An aesthetic perquisite of rectus muscle transplantation in extremity reconstruction

The authors combine a rectus abdominis muscle harvest with a mini-abdominoplasty in patients with Matarasso type II and III body types admitted for extremity reconstruction. The dermo-lipectomy tissue was used as a source for split-thickness skin graft. Twenty-five patients underwent the combined procedure. All flaps survived. Average quantity of skin harvested from the dermo-lipectomy tissue was 150 cm2 (range 100-250 cm2). Twenty-three of 25 (92%) required no additional skin grafting. The remaining 2 cases required less than 50 cm2 of additional split-thickness skin graft. There were no complications related to the mini-abdominoplasty. All patients were satisfied with their abdominal recontouring. The combined procedure results in an aesthetic improvement at the abdominal donor site and elimination or significant reduction of the morbidity related to a conventional skin graft donor site at the upper lateral thigh. This technique also allows thicker skin graft harvest without an associated increase in morbidity. The authors believe that this technique should be considered for patients with appropriate body habitus when a rectus abdominis muscle is the flap of choice or when multiple flaps including the rectus abdominis muscle are equal for the task.